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Result Normalization

Health Gorilla standardizes incoming lab results to FHIR to support downstream use in clinical decision-making, patient records, analytics, and care coordination. Normalization ensures that regardless of the source lab or result format, data is consistently structured, codified, and linked to the original order.

The solution processes both structured and unstructured results, maps them to standard code systems, and preserves clinical detail and provenance from the original lab feed.

Supported Result Formats

Labs return results in a range of formats, including:

  • Structured HL7 v2: Transformed to FHIR Observation and DiagnosticReport
  • Structured FHIR: Directly ingested with minimal transformation
  • CCDA attachments: Parsed and mapped to FHIR where possible
  • Unstructured documents: Returned as DocumentReference with attached Binary content

All results are stored and accessible through the FHIR API. Structured results are prioritized for analytics and clinical workflows, while unstructured results remain available for reference.

FHIR Mapping

Structured lab results are parsed and transformed into FHIR resources using the following mappings:

  • Test results: Observation
  • Result panels: DiagnosticReport
  • Attached PDFs or images: DocumentReference
  • Original transmission metadata: Provenance

Mapped values use standardized code systems when available:

  • LOINC: Test codes
  • SNOMED CT: Interpretation and specimen site
  • UCUM: Units of measure
  • Source lab-specific codes: Preserved in coding.system when normalization is not possible

Attribute Normalization

During processing, the solution standardizes result fields to enable consistent querying, display, and decision support.

Key normalized attributes include:

  • Observation.code: Mapped to LOINC
  • Observation.valueQuantity.unit: Mapped to UCUM
  • Observation.interpretation: Mapped to SNOMED CT or standard HL7 interpretation codes
  • Observation.referenceRange: Included when provided by the source lab
  • DiagnosticReport.status: Set based on result completeness and delivery state

Normalization rules prioritize clinically accurate mapping and transparent fallback to source representation when standardization is not possible.

Preserving Provenance

Each normalized result includes traceability back to the original source. This ensures data integrity and allows your system to distinguish between native FHIR results and those transformed from HL7 or other formats.

Provenance is preserved through:

  • Provenance.target: Links to the result resource
  • Provenance.agent: Identifies the source system
  • Observation.meta.tag: Flags normalized results with standardized processing tags
  • DocumentReference.context.related: Connects unstructured results to the related Requisition or ServiceRequest

You can query normalized results selectively using filters on meta.tag, Observation.code, or Provenance.agent.

Summary

The solution normalizes lab results from multiple sources into structured FHIR resources to ensure consistency, accuracy, and usability. Mapped values use standard clinical code systems when possible and retain source data for traceability. Both structured and unstructured results are accessible via the FHIR API, linked to the originating order and enriched with provenance for clinical validation and audit.